A framework for the design, development and implementation of technology platforms in the South African health context

[摘要] ENGLISH ABSTRACT: Healthcare in South Africa is in dire need of effective and sustainable solutions. Low life expectancy,high maternal and neonatal mortality, the impact of HIV and increasing non-communicable diseasesare compounded by the limited availability of skilled healthcare professionals. Initiatives such as theSustainable Development Goals aim to address these issues by working towards good health and wellbeingparticularly in developing countries. Technology platforms can provide much-needed solutionsto these above-mentioned issues. Ways in which such platforms can provide solutions include theability to communicate information, remotely monitor patients, collect and analyse data and enablepersonalised medicine. Therefore, technology platforms could potentially be a valuable asset in themission to improve healthcare in developing countries such as South Africa.However, the healthcare sector has been resistant to platform adoption due to characteristics such assensitive data and high cost of failure. Research has confirmed the differences in platformimplementation across countries, but a focus on implementation in the context of developingcountries such as South Africa is limited. A framework for the design, development andimplementation of technology platforms in the South African health context could thereforecontribute to the gap in research as well as provide a practical tool that platform owners could use topotentially increase the adoption of platforms in this context.This study aimed to develop a framework that can be used in the design, development andimplementation of technology platforms in the South African health context. In order develop theframework, the researcher developed eight research objectives that were grouped into two mainphases. The first phase included the framework development, while the second comprised theframework evaluation, specifically within the South African health context. Subsequently, a suitableresearch design was developed and implemented that enabled the researcher to meet the projectobjectives.The research design for this study was based on the Grounded Theory Conceptual Framework Analysisprocess developed by Jabareen (2009). The process focused on mapping and investigating datasources, categorising and integrating concepts, synthesising these concepts into a framework anditeratively evaluating the framework. The research design comprised four overarching parts thataligned with the Conceptual Framework Analysis process. The first part of the research design aimedto establish the context and aims of the study. Thereafter the focus shifted to formulating thepreliminary framework and its subsequent progressive evaluation process. The concluding part of thestudy presented and discussed the final framework and management tool.The first step in the research included a systematic literature review to develop an overall picture ofthe relevant research and identify possible gaps. This included identifying the key concepts related totechnology platforms in innovation ecosystems as well as the multidisciplinary nature of this research.As a part of the systematic literature review results, the void of related research in Africa, challengesfor platform owners, the three different platform ecosystem actors as well as several guiding principleswere uncovered.Subsequently, a conceptual literature review was done to further investigate key concepts and ideas.This included an understanding of the ecosystem metaphor and thirteen fundamental characteristicsof platforms and ecosystems. The context in which such a platform ecosystem would operate wasinvestigated in terms of the ecosystem actors and the South African health context. The literaturereview also included the investigation and analysis of existing frameworks, models and tools (FMTs)related to platform design and platform and ecosystem management. The FMTs provided much-needed insight into the structure, use and layout of the proposed framework and highlighted gaps inthese existing FMTs currently available to platform owners.The preliminary framework, constructed as a result of the systematic and conceptual literaturereviews, had to be evaluated. The evaluation process comprised three components, namely atheoretical case study, semi-structured interviews and an industry-based case study. Subsequent toeach of these components, the framework was modified and adapted. The components of theevaluation process also accounted for significant insights into the South African health context. As aresult of the evaluation process, the final framework was developed.The final framework can be used by platform owners as a management tool. This tool comprises sixcanvasses: (1) Pre-use Canvas, (2) Overview Canvas, (3) Platform Owner Canvas, (4) Developer Canvas,(5) End-user Canvas and (6) Platform Development Canvas. These canvasses are divided into twodimensions, namely an ecosystem dimension and a platform development dimension. The ecosystemdimension includes a canvas for each of the three platform ecosystem actors. These ecosystemcanvasses provide insights and questions regarding each of the ecosystem actors. The PlatformDevelopment Canvas aims to lead the platform owner into action and guides the platformdevelopment process. This Canvas comprises five parts, namely the platform core, the desiredecosystem and environment, the design of the platform and governance, the managing and operationand evolution of the platform and ecosystem.The framework and tool make a contribution to research. The framework was designed to be apractical tool with a user-centric focus. The framework therefore provides a platform owner withinsight into the ecosystem actors and practical elements to design and manage the platform andecosystem. The framework was also developed taking into account typical challenges that a platformowner would face. Another unique contribution is that the framework draws from two platformperspectives, namely the engineering and the economic perspectives. These perspectives are mostlyviewed in isolation despite the fact that when combined, they provide a more holistic understandingof platforms. The final contribution is the tailoring of the framework for the South African healthcontext. Particularly the End-user Ecosystem Canvas transformed significantly throughout theevaluation phases to suit the South African health context.The final framework and tool therefore met the project objectives. The framework should howevercontinuously evolve to remain relevant and usable to platform owners and to sustain its use as a toolto facilitate the adoption of technology platforms in the South African health context.

[发布机构] Stellenbosch University